Individual
RANDOLPH WES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
12345 SW HORIZON BLVD STE 57, BEAVERTON, OR 97007-9475
(503) 216-8825
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016287
OR
235Z00000X
Speech-Language Pathologist
112945
TX
Other
Enumeration date
07/10/2017
Last updated
07/21/2022
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